GSTR - 05A, Integrated Tax (GST-FORMS)

1. GSTIN of the supplier- 2. (a) Legal name of the registered person - (b) Trade name, if any - 3. Name of the Authorised representative in India filing the return – 4. Period: Month - Year - 5. Taxable outward supplies made to consumers in India (Amount in Rupees) Place of supply (State/UT) Rate of tax Taxable value Integrated tax Cess 1 2 3 4 5 5A. Amendments to taxable outward supplies to non-taxable persons in India (Amount in Rupees) Month Place of supply (State/UT) Rate of tax Taxable value Integrated tax Cess 1 2 3 4 5 6 6. Calculation of interest, penalty or any other amount Sr. No. Description Amount of tax due Integrated tax CESS 1 2 3 4 1. Interest 2. Others (Please specify) Total 7. Tax, interest, late fee and any other amount payable and paid Sr. No. Description Amount payable Amount paid Integrated tax CESS Integrated tax CESS 1 2 3 4 5 6 7 1. Tax Liability (based on Table 5 & 5A) 2. Interest (based on Table 6) 3. Others (Please Specify) Verification I hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom. Signature Name of Authorised Signatory Designation /Status Place Date